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The ABCDE's of Melanoma

Posted: 11:14 AM, May 03, 2024
Updated: 2024-05-03 11:18:58-04
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BALTIMORE, MD — Chances are you know someone, or you have had to deal with some form of skin cancer.

According to the American Academy of Dermatology, one in five people in the United States will develop skin cancer in their lifetime, and it's estimated 9,500 people in the US are diagnosed with a form of skin cancer every day.

May is skin cancer awareness month, and the first Monday of May is Melanoma Monday.

Melanoma is the deadliest form of skin cancer.

We wanted to go In Focus, so we turned to the expert Dr. Edward C. McCarron, MD FACS a Surgical Oncologist at MedStar Franklin Square Medical Center, where the Maryland Melanoma Center is located.

We have to warn you some of the photos in this article are hard to look at, but that's the point, to raise awareness so you can protect yourself and your loved ones.

These are the questions we asked Dr. McCarron.

What is melanoma?

Melanoma is a dangerous type of skin cancer.

Cancer develops when normal cells start to grow out of control. These abnormal cells may spread to other parts of your body and become life-threatening.

Melanoma originates from melanocytes which are normal cells in a person’s skin. Melanocytes produce melanin or pigment which gives skin its tan or brown color.

Melanoma starts in the outer layer of the skin called the epidermis. Abnormal cells then grow through the basement membrane into the dermis where they have the potential to spread to other parts of the body through lymphatic vessels or blood vessels.

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Why is it the most serious of the skin cancers?

Melanoma skin cancer is less common but more dangerous. If melanoma is not found and treated early, then it is much more likely to spread to other parts of a person’s body. More extensive surgery may be required to remove these tumors. Also, systemic therapy may be required to treat cancer cells throughout a person’s body.

The most common types of skin cancer are Basal cell carcinoma and Squamous cell carcinoma. These cancers are referred to as non-melanoma skin cancers. Physicians view these cancers as a nuisance because they typically do not spread to other parts of the body. They require local treatments such as excision, Mohs surgery, cryotherapy, and topical creams. Most people know a friend or family member who has dealt with this problem.

So now that we know what it is, what do we have to look for?

The ABCDE rule is an important guide for recognizing melanoma. Also, Dr. McCarron says do not ignore a sore that does not heal.

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A new dark spot on the skin or a change in an existing mole are the most important warning signs for melanoma.

Dr. McCarron also says to look for skin lesions that stand out from the rest of the moles on your body. The so-called “ugly duckling”.

At what age should I get my skin checked regularly? 

The American Cancer Society recommends people get a professional skin exam between the ages of 20 to 40. Annual exams should start at age 40.

Most patients are diagnosed with melanoma in the sixth decade of life.

The risk for developing melanoma increases with age.

However, melanoma is one of the most common cancers in young adults even those less than 30.

Lifetime risk of getting melanoma – White people 1 in 38; Black people 1 in 1,000; Hispanic people 1 in 167.

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What’s the treatment if caught early/late?

The risk associated with a melanoma is determined by its depth of invasion into the skin. Oncologists typically divide melanomas into thin, intermediate, and thick.

The best treatment for thin early-stage melanoma is surgery. A rim of normal skin is removed along with the melanoma to obtain clear margins. This operation is called a wide excision.

Wide excision may be done with local anesthesia or general anesthesia depending on the size of the lesion.

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Intermediate melanoma may require a sentinel lymph node biopsy. This procedure requires the removal of regional lymph nodes identified by lymphatic mapping. The sentinel lymph node biopsy may detect microscopic spread of melanoma to regional lymph nodes. If a sentinel lymph node is positive, then a patient may opt for systemic therapy

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As with all cancers, and most medical conditions, prevention is key. Dr. McCarron says "The easiest cancer to treat is the one a person never gets. However, once a patient has cancer, treatment intensifies as the tumor progresses from earlier to later stages. Most melanoma patients are diagnosed at an early stage, and they have excellent survival with simple outpatient surgery. Melanoma patients diagnosed at later stages also have excellent treatment options to optimize both quantity and quality of life."

Listen to the people around you.

And one last bit of advice, listen to the people around you! Sometimes you may not notice a change but others will. That's what happened to Jamie Costello whose hairstylist noticed something different.

Hair stylist helps WMAR-2 News anchor Jamie Costello face skin cancer